Effect of smoking status on successful arthrodesis, clinical outcome and complications after anterior lumbar interbody fusion (ALIF).

Effect of smoking status on successful arthrodesis, clinical outcome and complications after anterior lumbar interbody fusion (ALIF).

World Neurosurg. 2017 Dec 06;:

Authors: Phan K, Fadhil M, Chang N, Giang G, Gragnaniello C, Mobbs RJ

Abstract
BACKGROUND: Anterior lumbar interbody fusion (ALIF) is a surgical technique indicated for the treatment of several lumbar pathologies. Smoking has been suggested as a possible cause of reduced fusion rates following ALIF, though the literature regarding the impact of smoking status on lumbar spine surgery is not well established. This study aims to assess the impact of perioperative smoking status on the rates of perioperative complications, fusion and adverse clinical outcomes in patients undergoing ALIF surgery.
METHODS: A retrospective analysis was performed on a prospectively maintained database of 137 patients, all of whom underwent ALIF surgery by the same primary spine surgeon. Smoking status was defined by the presence of active smoking in the 2 weeks prior to the procedure. Outcome measures included fusion rates, surgical complications, Short-Form 12 (SF-12) and Oswestry Disability Index.
RESULTS: Patients were separated into non-smokers (n = 114) and smokers (n = 23). Univariate analysis demonstrated that the percentage of patients with successful fusion differed significantly between the groups (69.6% vs. 85.1%, P = 0.006). Pseudoarthrosis rates were shown to be significantly associated with perioperative smoking. Results for other postoperative complications and clinical outcomes were similar for both groups. On multivariate analysis, the rate of failed fusion was significantly higher for smokers than non-smokers (OR 37.10, P = 0.002).
CONCLUSIONS: The rate of successful fusion after ALIF surgery was found to be significantly lower for smokers compared to non-smokers. No significant association was found between smoking status and other perioperative complications or adverse clinical outcomes.

PMID: 29223523 [PubMed - as supplied by publisher]

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